Film/Video/TV Annotations


The Citadel


MediumFilm
KeywordsArt of Medicine, Cross-Cultural Issues, Disease and Health, Doctor-Patient Relationship, History of Medicine, Human Worth, Individuality, Love, Medical Ethics, Medical Research, Occupational Disease, Physician Experience, Poverty, Power Relations, Professionalism, Public Health, Society, Tuberculosis
Summary

Idealistic, nervous, and rigid, Andrew Manson (Robert Donat) takes his first medical job as an assistant to a doctor in a Welsh mining community. The greedy wife of his invalid employer obliges Manson to hand over most of his earnings. But he finds a local kindred spirit in the outspoken Dr. Denny (Ralph Richardson). In a drunken prank, they blow up the town sewer forcing the unwilling government to repair a notorious source of typhoid.

Manson marries a beautiful school teacher (Rosalind Russell) who leaves her beloved classroom to follow him to an even larger mining town. There he is employed by a group practice run on a capitation basis by the miners. In their evenings, the Mansons investigate the problem of chronic cough in miners, linking it to tuberculosis and coal dust--a discovery that they publish. But suspicious miners destroy their laboratory and force them to London and poverty.

A chance encounter with a wealthy hysteric and an old mate (Rex Harrison) raises Manson’s social standing. He opens a Harley Street practice and makes a fortune. His wife regrets the loss of his ideals and the death of his research. She begs him to remember how happy they were in poverty when each day was a noble challenge to take "the citadel" of life. Denny returns to entice Manson into a new group practice funded by community insurance, but Manson flatly refuses. Denny’s accidental death and a blunder by an elite, unethical Harley Street surgeon bring Andrew back to his idealistic senses.

The film closes with his eloquent self defense against charges of irregular practice for having intervened (successfully) in the case of a little girl with tuberculosis. Manson assists as the child is treated gratis with the controversial new pneumothorax operation administered by an American who does not hold a medical degree. Whether or not Manson keeps his license, the audience is confident that his sense of purpose has been restored and that his wife loves him more than ever. He will return both to the comfortably compatible pursuits of research and serving the sick poor.

Commentary

Cronin’s semi-autobiographical novel of the same name had sold nearly 200,000 copies within a year of its release when it was turned faithfully into this film--an historical gem. It addresses the early twentieth century’s confidence in science and its experiments in socialized health-care provision. As a Harley Street doctor, Manson is uncaring AND unscientific; his redemption involves not only a return to charity but a return to research. This British compatibility of science and caring stands in contrast to the tension perceived between the two pursuits in 0009, the American novel, and in the film, 0093 of the same era (both annotated in this database).

It is said that the immense popularity of Cronin’s novel and the film played a role in paving the way to the British National Health Service a decade later. Nevertheless, the producers placed an apologetic warning after the opening credits to distance themselves from the selfishness of some doctors portrayed by the film and to state that no insult was intended to the noble profession that has done so much to help humanity. Indeed, Cronin’s stature with the medical profession suffered for his socialist ideals. For more on Cronin see Dale Salwak, A.J. Cronin (Boston: Twayne Publishers, 1985).

Interesting short clips for class discussion on areas of social policy can be made of Manson’s first interview with the miners or of Denny’s later entreaties to join a group practice--both of which offer idealistic portrayals of what could be called pre-Beveridge HMO’s. Excellent performances by the actors, the Welsh accents, and welcome humor serve to soften the powerful moralizing message.

DirectorKing Vidor
Leading ActorsRobert Donat, Rex Harrison, Ralph Richardson, Rosalind Russell
StudioMGM
Year1938
Color/BWBlack And White
Running Time114 minutes
Based OnThe Citadel
Video SourceMGM/UA
MiscellaneousBased on the novel of the same name by physician author A.J. Cronin; Academy Award Nomination Best Actor for Donat
Annotated by Duffin, Jacalyn
Date of Entry 02/04/00
Last Revised 02/14/07